What does the analysis of the CHESS PAEDs study say about the relationship between physical activity and the frequency of bleeding events in children with hemophilia A?
Currently, there is limited published data addressing the relationship between physical activity and the occurrence of bleeding events in children with hemophilia A. To gain insights into this topic in real-world practice, data from the CHESS PAEDs study were analyzed. The results were presented in the poster section of the virtual congress of the International Society on Thrombosis and Haemostasis (ISTH).
Analyzed Data
The international CHESS PAEDs study (Cost of Haemophilia across Europe – Socioeconomic Survey in Paediatric Population) focused on the economic burden of hemophilia treatment in the population of European pediatric patients based on a socioeconomic survey and was conducted in 2017 in France, Germany, Italy, Spain, and the United Kingdom. Experts in the field of hemophilia provided researchers with data on pediatric hemophilia patients in their care, including demographic information, treatment types, and clinical outcomes, in accordance with ethical guidelines. Additionally, patients completed questionnaires assessing quality of life and activity levels (either directly or through caregivers).
Findings
A total of 138 children with hemophilia A who reported engaging in some form of physical activity were included in the analysis. The median number of hours (± standard deviation) spent weekly on reported physical activity was 23.8 (± 24.8) for patients with moderate hemophilia and 10.8 (± 11.3) in the group of children with severe forms of the disease. The median annual bleeding rate (ABR) was 4.3 (± 7.9) for children with moderate forms and 6.9 (± 18.7) in the group with severe hemophilia. The occurrence of bleeding events was significantly lower with prophylactic treatment compared to on-demand treatment.
Children who engaged in more intensive physical activity did not differ in age or BMI from others but were more likely to receive on-demand treatment. They also had a higher median ABR compared to children who engaged only in light and/or moderate physical activity (8.0 ± 21.0 vs. 3.5 ± 3.7); however, the median ABR and the proportion of patients without any bleeding event (“with zero bleeding”) were similar. No clear trend in ABR was observed between pediatric patients with hemophilia A who took medication prior to intensive physical activity and those who did not.
Conclusion
This 2017 study suggests a slightly higher incidence of bleeding in pediatric patients A with greater involvement in physical activities. This could indicate that prophylactic therapy, although used by 78% of all study participants, was suboptimal in real-world practice. These findings should be interpreted with caution, considering the small study sample and the potential inaccuracy of some information. They highlight the potential needs in treatment and clinical burden for physically active children with moderate to severe hemophilia A undergoing treatment involving the substitution of the missing coagulation factor VIII.
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Source: Ofori-Asenso R., Nissen F., Silkey M. et al. Association of physical activity with bleeding frequency in children with hemophilia A: a CHESS PAEDs study analysis. ISTH Congress 2021. Res Pract Thromb Haemost 2021; 5 (Suppl. 1): PB0512. Available at: https://abstracts.isth.org/abstract/association-of-physical-activity-with-bleeding-frequency-in-children-with-hemophilia-a-a-chess-paeds-study-analysis
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